Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-24T10:58:22.433Z Has data issue: false hasContentIssue false
  • English
  • Français

Aspiration pneumonia related deaths in head and neck cancer patients: a retrospective analysis of risk factors from a tertiary care centre in North India

Published online by Cambridge University Press:  16 June 2015

R Madan ,
A K Kairo ,
A Sharma ,
S Roy ,
S Singh ,
L Singh ,
J Kaur ,
B K Mohanti ,
S Bhasker  and
A D Upadhyay
...Show all authors
R Madan*
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
A K Kairo
Affiliation:
Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, India
A Sharma
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
S Roy
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
S Singh
Affiliation:
Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, India
L Singh
Affiliation:
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
J Kaur
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
B K Mohanti
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
S Bhasker
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
A D Upadhyay
Affiliation:
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
G K Rath
Affiliation:
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
*
Address for correspondence: Dr R Madan, Department of Radiotherapy, R. No. 29, Ground floor, Dr BRA, IRCH, All India Institute of Medical Sciences, New Delhi-110029, India E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Aspiration pneumonia is an important cause of death in head and neck cancer patients. This study therefore aimed to evaluate the risk factors associated with aspiration pneumonia in head and neck cancer patients.

Methods:

Hospital death records from 12 years (2000–2012) were reviewed to obtain the number of deaths. Treatment details and cause of death were analysed. Statistical analysis was performed to identify the risk factors for aspiration pneumonia.

Results:

The records revealed that aspiration pneumonia was the cause of death in 51 out of 85 patients. Primary tumour site (oropharynx and hypopharynx, odds ratio 3.3; 95 per cent confidence interval 1.17–9.4, p = 0.02) and advanced tumour stage (odds ratio 4.2, 95 per cent confidence interval 1.16–15.61, p = 0.02) had significant negative impacts on aspiration pneumonia related mortality.

Conclusion:

Advanced pharyngeal cancer patients are at an increased risk of aspiration pneumonia related death. Investigations for the early detection of this condition are recommended in these high-risk patients.

Keywords

Head and Neck CancerChemoradiotherapyAspiration PneumoniaDeathIndia
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 7 , July 2015 , pp. 710 - 714
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented as an oral presentation at the 1st Indian Cancer Congress, 21–24 November 2013, New Delhi, India

References

1Ferlay, J, Soerjomataram, I, Ervik, M, Dikshit, R, Eser, S, Mathers, C et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. In: http://globocan.iarc.fr/Default.aspx [28 May 2015]Google Scholar
2Mohanti, BK, Nachiappan, P, Pandey, RM, Sharma, A, Bahadur, S, Thakar, A. Analysis of 2167 head and neck cancer patients' management, treatment compliance and outcomes from a regional cancer centre, Delhi, India. J Laryngol Otol 2007;121:49–56CrossRefGoogle ScholarPubMed
3Pignon, JP, le Maître, A, Maillard, E, Bourhis, J; MACH-NC Collaborative Group. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 2009;92:4–14CrossRefGoogle Scholar
4Batth, SS, Caudell, JJ, Chen, AM. Practical considerations in reducing swallowing dysfunction following concurrent chemo radiotherapy with intensity-modulated radiotherapy for head and neck cancer. Head Neck 2014;36:291–8CrossRefGoogle Scholar
5Nguyen, NP, Frank, C, Moltz, CC, Vos, P, Smith, HJ, Bhamidipati, PV et al. Aspiration rate following chemoradiation for head and neck cancer: an underreported occurrence. Radiother Oncol 2006;80:302–6CrossRefGoogle ScholarPubMed
6Stenson, KM, Mccracken, E, List, M, Haraf, DJ, Brockstein, B, Weichselbaum, R et al. Swallowing function in head and neck cancer patient prior to treatment. Arch Otolaryngol Head Neck Surg 2000;126:384–9CrossRefGoogle ScholarPubMed
7Russi, EG, Corvò, R, Merlotti, A, Alterio, D, Franco, P, Pergolizzi, S et al. Swallowing dysfunction in head and neck cancer patients treated by radiotherapy: review and recommendations of the supportive task group of the Italian Association of Radiation Oncology. Cancer Treat Rev 2012;38:1033–49CrossRefGoogle ScholarPubMed
8Marik, PE. Aspiration pneumonitis and aspiration pneumonia. N Engl J Med. 2001;344:665–71CrossRefGoogle ScholarPubMed
9Langerman, A, Maccracken, E, Kasza, K, Haraf, DJ, Vokes, EE, Stenson, KM. Aspiration in chemoradiated patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 2007;133:1289–95CrossRefGoogle ScholarPubMed
10Mortensen, HR, Jensen, K, Grau, C. Aspiration pneumonia in patients treated with radiotherapy for head and neck cancer. Acta Oncol 2013;52:270–6CrossRefGoogle ScholarPubMed
11Jung, SJ, Kim, DY, Joo, SY. Risk factors associated with aspiration in patients with head and neck cancer. Ann Rehabil Med 2011;35:781–90CrossRefGoogle ScholarPubMed
12Kotz, T, Costello, R, Li, Y, Posner, MR. Swallowing dysfunction after chemo-radiation for advanced squamous cell carcinoma of the head and neck. Head Neck 2004;26:365–72CrossRefGoogle Scholar
13Langmore, SE, Schatz, K, Olson, N. Endoscopic and video-fluoroscopic evaluations of swallowing and aspiration. Ann Otol Rhinol Laryngol 1991;100:678–81Google Scholar
14Smith, RV, Kotz, T, Beitler, JJ, Wadler, S. Long-term swallowing problems after organ preservation therapy with concomitant radiation therapy and intravenous hydroxyurea. Arch Otolaryngol Head Neck Surg 2000;126:384–9CrossRefGoogle ScholarPubMed
15Nguyen, NP, Smith, HJ, Dutta, S, Alfieri, A, North, D, Nguyen, PD et al. Aspiration occurrence during chemoradiation for head and neck cancer. Anticancer Res 2007;27:1669–72Google ScholarPubMed
16Hunter, KU, Lee, OE, Lyden, TH, Haxer, MJ, Feng, FY, Schipper, M, Worden, F, Prince, ME, McLean, SA, Wolf, GT, Bradford, CR, Chepeha, DB, Eisbruch, A. Aspiration pneumonia after chemo-intensity-modulated radiation therapy of oropharyngeal carcinoma and its clinical and dysphagia-related predictors. Head Neck 2014;36:120–5CrossRefGoogle ScholarPubMed